External Validity of ADHD Inattention and Sluggish Cognitive Tempo Dimensions in Spanish Children With ADHD

Fenollar-Cortés, Javier; Servera, Mateu; Becker, Stephen P.; Burns, G. Leonard

doi:10.1177/1087054714548033

Cited by 52 publications

(65 citation statements)

References 29 publications

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“…Interestingly, in the regression analyses SCT remained significantly associated with depression but not anxiety. This finding adds to a small but growing body of research indicating that while SCT is clearly associated with internalizing symptoms, this seems to be more specific to depression as opposed to anxiety (Barkley, 2013, Becker et al, 2014a, Fenollar Cortés et al, 2014, Garner et al, 2013, Jacobson et al, 2012). Depression and anxiety are both characterized by high negative affect, but can be differentiated based on physiological hyperarousal (anxiety) or low positive affect/anhedonia (depression) (Anderson and Hope, 2008, Clark and Watson, 1991).…”

Section: Discussionmentioning

confidence: 51%

Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment

Becker

Garner

Byars

2016

Journal of Psychiatric Research

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Research supports the distinctness of sluggish cognitive tempo (SCT) (e.g., mental confusion and slowed behavior/thinking) from other psychopathologies. However, the relation between SCT and sleep functioning has not been adequately studied. We examined the association between SCT and sleep functioning in 325 children (62% male) ages 6-10 years referred to a pulmonary-based, accredited Sleep Disorders Center. Correlations between caregiver ratings of SCT, other psychopathologies (i.e., inattention/hyperactivity, oppositionality, depression, anxiety), sleep functioning (both behavioral and organic symptoms), as well as sleep disorder diagnoses, were examined. Unique effects of SCT and other psychopathologies on sleep problem severity controlling for child demographics were assessed using regressions. Regression analyses were also conducted to examine the unique effects of SCT on impairment (i.e., academic difficulties, parenting stress, and other psychopathologies) controlling for child demographics, sleep problem severity, and other psychopathology symptoms. SCT was weakly to moderately correlated with most measures of sleep (rs=.07-.39) and moderately to strongly correlated with measures of daytime sleepiness (rs=.33 and .53). SCT was uniquely associated with greater sleep functioning severity and impairment in academic functioning. SCT was also uniquely associated with higher levels of depression and inattention/hyperactivity, but not anxiety, and negatively associated with oppositionality. Finally, SCT symptoms were uniquely associated with greater parent-child dysfunctional interaction. Findings demonstrate that SCT is related to, but not redundant with, sleep problems and daytime sleepiness specifically. Further, SCT remained associated with several domains of functional impairment in sleep-disordered children after controlling for clinically-relevant variables, highlighting the potential value in assessing SCT symptoms in children with sleep problems.

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Section: Discussionmentioning

confidence: 51%

Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment

Becker

Garner

Byars

2016

Journal of Psychiatric Research

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“…Whereas studies show SCT symptoms to remain positively associated with internalizing symptoms when controlling for ADHD inattention symptoms, several studies found SCT to be unassociated or negatively associated with hyperactive-impulsive and externalizing symptoms when controlling for ADHD inattention 14,20,24,25,30–33,42 . In contrast, ADHD inattention remains associated with hyperactive-impulsive and externalizing symptoms when controlling for SCT symptoms, pointing to an important double dissociation of SCT and ADHD inattention symptoms that provides further support for the distinctiveness of SCT from ADHD.…”

Section: Resultsmentioning

confidence: 93%

“…Table 4 summarizes meta-analytic results of all available studies that examined the reliability of measures of SCT (Table S2, available online, lists all studies included in these summary statistics). For studies that reported results separately for different SCT factors (e.g., 14,25 ), the mean of these results was included as the single effect from the study. All analyses were repeated with and without these studies included in the analysis, and the overall pattern of results did not change.…”

Section: Resultsmentioning

confidence: 99%

“…Given the wide variability in the SCT item sets used across studies to date, we were unable to address this issue in the current meta-analysis (see Table 2 for a descriptive summary). Several recent studies have found that SCT may be multidimensional 14,17,25,29,30,32 , although a large study of youth with and without ADHD 34 and a population-based study of adults 16 both found SCT symptoms to load on a single factor. Also, while initial findings evaluating a child self-report version of Penny’s measure found support for a three-factor structure, bi-factor modeling and omega hierarchical reliability statistics indicated that the measure is best considered as unidimensional rather than multidimensional 21 .…”

Section: Discussionmentioning

confidence: 99%

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The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review

Becker

Leopold

Burns

et al. 2016

Journal of the American Academy of Child & Adolescent Psych

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274

519

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Objective To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Method Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Results Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including over 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, inter-rater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (rs = 0.38–0.44). Effects for neuropsychological functioning are mixed, although there is initial support for SCT being associated with processing speed, sustained attention, and metacognitive deficits. Conclusion This meta-analytic review provides strong support for the internal validity of SCT and preliminary support for the external validity of SCT. In terms of diagnostic validity, there is not currently enough evidence to describe SCT in diagnostic terms. Key directions for future research are discussed, including evaluating the conceptualization of SCT as a transdiagnostic construct and the need for longitudinal research.

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“…It is therefore perhaps not surprising that SCT was unrelated to poor study skills in this domain since SCT is not characterized by rushing and impulsive behaviors but rather slowed behavior and thinking (Barkley, 2014; Becker, 2013; Becker, Leopold et al,2016). Thus, the slow aspect of SCT may be a primary contributor to academic problems even when comprehension is high (Becker, Ciesielski, et al, 2016; Fenollar Cortés, Servera, Becker, & Burns, 2014; Langberg, Becker, & Dvorsky, 2014; Tamm et al, 2016). Additional research will be needed to replicate the differential finding of the present study that SCT impacts the affective learning and goal strategies study skills domains but not the comprehension monitoring domain.…”

Section: Discussionmentioning

confidence: 99%

Sluggish Cognitive Tempo is Associated With Poorer Study Skills, More Executive Functioning Deficits, and Greater Impairment in College Students

2016

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Objectives Few studies have examined sluggish cognitive tempo (SCT) in college students even though extant research suggests a higher prevalence rate of SCT symptoms in this population compared to general adult or youth samples. The current study examined SCT symptoms in relation to two domains related to college student’s academic success, study skills and daily life executive functioning (EF), as well as specific domains of functional impairment. Method 158 undergraduate students (Mage=19.05 years; 64% female) completed measures of psychopathology symptoms, study skills, daily life EF, and functional impairment. Results After controlling for demographics and symptoms of attention-deficit/hyperactivity disorder (ADHD), anxiety, and depression, SCT remained significantly associated with poorer study skills, greater daily life EF deficits, and global impairment, as well as greater functional impairment in the specific domains of educational activities, work, money/finances, managing chores and household tasks, community activities, and social situations with strangers and with friends. In many instances, ADHD inattentive symptoms were no longer significantly associated with study skills or impairment after SCT symptoms were added to the model. Conclusion SCT is associated with poorer college student functioning. Findings highlight the need for increased specificity in studies examining the relation between SCT and adjustment.

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External Validity of ADHD Inattention and Sluggish Cognitive Tempo Dimensions in Spanish Children With ADHD

Abstract: The findings support SCT to be a construct with two dimensions that have unique correlates relative to each other as well as ADHD-IN. Future research on SCT should separate these dimensions of SCT to provide a better understanding of the construct.

Cited by 52 publications

References 29 publications

Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment

Sluggish cognitive tempo in children referred to a pediatric Sleep Disorders Center: Examining possible overlap with sleep problems and associations with impairment

The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review

Sluggish Cognitive Tempo is Associated With Poorer Study Skills, More Executive Functioning Deficits, and Greater Impairment in College Students

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